Evaluation of the Obstetric Quality-of-Recovery score (ObsQoR-11) following non-elective caesarean delivery.


Journal

International journal of obstetric anesthesia
ISSN: 1532-3374
Titre abrégé: Int J Obstet Anesth
Pays: Netherlands
ID NLM: 9200430

Informations de publication

Date de publication:
08 2019
Historique:
received: 18 10 2018
revised: 02 01 2019
accepted: 20 01 2019
pubmed: 20 3 2019
medline: 1 2 2020
entrez: 20 3 2019
Statut: ppublish

Résumé

Few robust scoring tools exist to assess recovery following caesarean delivery (CD). We evaluated a new obstetric quality of recovery score (ObsQoR-11, initially formulated for elective CD) following non-elective CD. ObsQoR-11 questionnaires were completed by women at day one post non-elective CD. Convergent validity was assessed by correlation of ObsQoR-11 with a 100 mm numerical rating scale (NRS) of general health status; discriminant validity by correlation with good vs poor recovery (NRS of ≥70 vs <70 mm, respectively); and content validity by correlation with length of stay (LOS), CD category, parity, gestation, previous CD, duration, blood loss, haemoglobin, age and body mass index. Cronbach's alpha, inter-item, split-half and test-retest correlation assessed reliability. Feasibility was tested by recruitment rate and time for ObsQoR-11 completion. One hundred women completed ObsQoR-11 at 24 h and 20 women repeated it at 25 h. ObsQoR-11 correlated strongly with NRS (r = 0.72 [95% CI 0.61 to 0.81], P <0.0001); discriminated well between good versus poor recovery (median [IQR] score 97 [86.5-101] vs 64 [50.5-78.5], P <0.0001); correlated to LOS (r = -0.24 [-0.42 to -0.04], P=0.02) and parity (r = 0.24 [0.04 to 0.42], P=0.02). Reliability was acceptable: Cronbach's alpha 0.75; inter-item correlation >0.15; split-half reliability 0.96; and intra-class correlation >0.6; no floor or ceiling effects. One hundred percent completed the ObsQoR-11 (median [IQR] completion time 117 [89-156] s). ObsQoR-11 is valid and reliable in assessing recovery after non-elective CD. Further research should assess generalisability and use following vaginal delivery.

Sections du résumé

BACKGROUND
Few robust scoring tools exist to assess recovery following caesarean delivery (CD). We evaluated a new obstetric quality of recovery score (ObsQoR-11, initially formulated for elective CD) following non-elective CD.
METHODS
ObsQoR-11 questionnaires were completed by women at day one post non-elective CD. Convergent validity was assessed by correlation of ObsQoR-11 with a 100 mm numerical rating scale (NRS) of general health status; discriminant validity by correlation with good vs poor recovery (NRS of ≥70 vs <70 mm, respectively); and content validity by correlation with length of stay (LOS), CD category, parity, gestation, previous CD, duration, blood loss, haemoglobin, age and body mass index. Cronbach's alpha, inter-item, split-half and test-retest correlation assessed reliability. Feasibility was tested by recruitment rate and time for ObsQoR-11 completion.
RESULTS
One hundred women completed ObsQoR-11 at 24 h and 20 women repeated it at 25 h. ObsQoR-11 correlated strongly with NRS (r = 0.72 [95% CI 0.61 to 0.81], P <0.0001); discriminated well between good versus poor recovery (median [IQR] score 97 [86.5-101] vs 64 [50.5-78.5], P <0.0001); correlated to LOS (r = -0.24 [-0.42 to -0.04], P=0.02) and parity (r = 0.24 [0.04 to 0.42], P=0.02). Reliability was acceptable: Cronbach's alpha 0.75; inter-item correlation >0.15; split-half reliability 0.96; and intra-class correlation >0.6; no floor or ceiling effects. One hundred percent completed the ObsQoR-11 (median [IQR] completion time 117 [89-156] s).
CONCLUSIONS
ObsQoR-11 is valid and reliable in assessing recovery after non-elective CD. Further research should assess generalisability and use following vaginal delivery.

Identifiants

pubmed: 30885691
pii: S0959-289X(18)30515-6
doi: 10.1016/j.ijoa.2019.01.010
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

51-59

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

S Ciechanowicz (S)

University College London Hospital, London, UK. Electronic address: s.ciechanowicz@nhs.net.

R Howle (R)

University College London Hospital, London, UK.

C Heppolette (C)

University College London Hospital, London, UK.

B Nakhjavani (B)

University College London Hospital, London, UK.

B Carvalho (B)

Stanford University School of Medicine, Stanford, CA, USA.

P Sultan (P)

University College London Hospital, Honorary Senior Lecturer, University College London, London, UK.

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